Decreased Mortality in 1-Year Survivors of Umbilical Cord Blood Transplant vs. Matched Related or Matched Unrelated Donor Transplant in Patients with Hematologic Malignancies

Bohannon, Lauren; Tang, Helen; Page, Kristin; Ren, Yi; Jung, Sin‐Ho; Artica, Alexandra; Britt, Anne B.; Islam, Prioty; Siamakpour-Reihani, Sharareh; Giri, Vinay K.; Lew, M.; Kelly, Matthew S.; Choi, Taewoong; Gasparetto, Cristina; Long, Gwynn D.; Lopez, Richard D.; Rizzieri, David A.; Sarantopoulos, Stefanie; Chao, Nelson J.; Horwitz, Mitchell E.; Sung, Anthony D.

doi:10.1016/j.jtct.2021.05.002

Cited by 5 publications

(4 citation statements)

References 33 publications

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“…Our study showed lower neutrophil and platelet recovery for CBT compared to MSD HCT for advanced MDS, which is consistent with previous reports of various hematological diseases. [14][15][16][17][18] A lower and slower hematopoietic recovery is the major limitation of CBT for adults, which could contribute to higher risks of and infectious complications early after CBT. In fact, infection and graft failure are more common causes of death after CBT compared with MSD HCT.…”

Section: Grades Ii-iv Acute Gvhd Grades Iii-iv Acute Gvhdmentioning

confidence: 99%

“…Our study clearly demonstrated that CBT was associated with a lower risk of overall and extensive chronic GVHD compared with MSD HCT for advanced MDS, which is also in line with previous reports on various hematological diseases, particularly for extensive chronic GVHD. [14][15][16][17][18] The lower incidence of severe chronic GVHD is one of the most attractive advantages of CBT. [36][37][38] The development of chronic GVHD adversely affects not only physical and mental health but the social quality of life in allogeneic HCT survivors.…”

Section: Grades Ii-iv Acute Gvhd Grades Iii-iv Acute Gvhdmentioning

confidence: 99%

“…Several studies have demonstrated comparable or better survival for MSD HCT than CBT in adult patients with heterogenous hematological diseases. [14][15][16][17][18] However, there is no comparative data for MSD HCT and CBT restricted to adult patients with advanced MDS. Here, we used data from a Japanese database to retrospectively compare the outcomes of allogeneic HCT in adult patients with advanced MDS who received either MSD HCT or single-unit CBT.…”

Section: Introductionmentioning

confidence: 99%

“…These improvements have resulted in a drastic expansion of CBT for MDS in recent years. Several studies have demonstrated comparable or better survival for MSD HCT than CBT in adult patients with heterogenous hematological diseases 14–18 . However, there is no comparative data for MSD HCT and CBT restricted to adult patients with advanced MDS.…”

Section: Introductionmentioning

confidence: 99%

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Single‐unit unrelated cord blood transplantation versus HLA‐matched sibling transplantation in adults with advanced myelodysplastic syndrome: A registry‐based study from the adult MDS working group of the Japanese society for transplantation and cellular therapy

Konuma,

Itonaga,

Shimomura

et al. 2023

Hematological Oncology

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Allogeneic hematopoietic stem cell transplantation (HCT) remains the only potential curative therapeutic modality for advanced myelodysplastic syndrome (MDS). Within HCT, the advancement of cord blood transplantation (CBT) procedures has resulted in a drastic expansion of CBT as a donor source for MDS. However, data comparing matched sibling donors (MSDs) HCT with CBT for advanced MDS, which was defined as refractory anemia with an excess of blasts (RAEB)‐1 and RAEB‐2 according to the World Health Organization classification at the time of HCT, have not been explored. We retrospectively compared survival and other posttransplant outcomes in 999 adult patients with advanced MDS after receiving allogeneic HCT in Japan between 2011 and 2020, using either MSD (n = 331) or single‐unit unrelated cord blood (UCB) (n = 668). In the multivariate analysis, there were no significant differences in overall survival (hazard ratio [HR], 1.10; 95% confidence interval [CI], 0.90–1.34; P = 0.347), disease‐free survival (HR, 1.01; 95% CI, 0.84–1.23; P = 0.845), relapse (HR, 0.88; 95% CI, 0.68–1.15; P = 0.370), or non‐relapse mortality (HR, 1.15; 95% CI, 0.87–1.50; P = 0.310) between MSD recipients and UCB recipients. UCB was significantly associated with lower neutrophil (HR, 0.28; 95% CI, 0.24–0.33; P < 0.001) and lower platelet (HR, 0.29; 95% CI, 0.23–0.36; P < 0.001) recovery compared to MSD. UCB was significantly associated with a lower incidence of chronic graft‐versus‐host disease (GVHD) (HR, 0.57; 95% CI, 0.44–0.75; P < 0.001) and extensive chronic GVHD (HR, 0.46; 95% CI, 0.32–0.67; P < 0.001) compared to MSD. Similar results were observed after adjusting for differences between MSD and UCB recipients by propensity score matching analysis. Our study demonstrated that single CBT and MSD HCT had similar survival outcomes for adult patients with advanced MDS despite the lower hematopoietic recovery in CBT recipients and higher chronic GVHD in MSD recipients.

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